C1-C2 Posterior Screw-Rod Fixation

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Biomechanics

Background:

• Atlantoaxial instability was historically managed non-surgically due to the complexity and risks of operating on the upper cervical spine.
• The 20th century saw the development of surgical instrumentation to address this condition, aiming for safer and more effective treatments.
• Evolution of techniques focused on enhancing biomechanical stability and fusion rates for C1-C2 constructs.

Purpose of the Study:

• To provide a historical analysis of the evolution of upper cervical spine instrumentation techniques.
• To explore the development and prevailing Harms technique for C1-C2 instrumentation.
• To detail the surgical steps, alternatives, and outcomes associated with the Harms technique.

Main Methods:

• Historical review of surgical approaches for atlantoaxial instability.
• Analysis of the evolution of C1-C2 instrumentation techniques.
• Detailed description of the Harms technique, including surgical steps and outcomes.

Main Results:

• Surgical interventions have evolved from immobilization to complex instrumentation for atlantoaxial instability.
• The Harms technique has emerged as a prevailing method, improving biomechanical stability and fusion rates.
• Understanding of spinal biomechanics and anatomy is crucial for tailoring surgical plans.

Conclusions:

• The evolution of upper cervical spine instrumentation has transformed the treatment of atlantoaxial instability.
• The Harms technique represents a significant advancement in achieving stable and fused C1-C2 constructs.
• Successful instrumentation requires a comprehensive understanding of biomechanics, surgical techniques, and patient-specific anatomy.